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Swim Academy Enrolment Form

Parent/guardian details
Name:
Address
Additional parent guardian details
Name:
Program details
Swimming program preferred centre:
Student 1 details
Name:
Gender
Preferred days
Preferred time
Has your child previously participated in a swimming program?
Select the skills that this student can complete
Questions No Aid Assisted 5m 10m 15m 25m

Student 2 details
Name:
Child 2 Gender
Preferred days
Preferred time
Has your child previously participated in a swimming program?
Select the skills that this student can complete
Questions No Aid Assisted 5m 10m 15m 25m

Student 3 details
Name:
Child 3 Gender
Preferred days
Preferred time
Has your child previously participated in a swimming program?
Select the skills that this student can complete
Questions No Aid Assisted 5m 10m 15m 25m
Emergency contact
Name:
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